HomeMy WebLinkAbout064-690-021! BUTTE COUNTY SCHOOLS IMPACT••FEE CERTIFICATION FORM
(One form per Building)
School DistrictG�a �\ t Building Department No.
A.P.{Number Q�r.k�-Y t0'Vo� Jurisdiction: City County
Property Owner r
Property Location/Address l
Subdivision Lot No.
\.......................................................................................,
Residential Development Q Q Sq. Footage
No of Living M)aile ome Addition/ "Supplemental.to (Group. R)
Units Installation Conversion Permit #
.(No foundation inspection)
........................................................................................
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Commercial/Industrial 0 0 _ Sq. Footage
New Addition (Including Exterior
Roofed Areas)
Building Department Repre en tive P Date jam`
Dist 'ct Identification No.
i School District certifies that
_. (APPlicafit)
a7.
Address)
//1
(State)
has complied with the requirements of Resolution No.
representing square feet.
School District
Paid by Check # Remarks:
S - Z — -33c
(Phone Number)
(Zip Code)
by payment of $ 7 6- 3 2
1pii3 2926 $
ULL MITIGATION $
g-P/vs
Date
Notice: You may protest the Imposition of the fees Identified above by submitting a wrMen protest to the District; In compliance with
Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the Imposition of the fees In any court action.
U, subsequent to the School District Representative signing thhi Butte County Schools Impact Fee Certification Form, the School Dlstrlet Is
notified by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CEQA),
this project may be subject to additional school fees to fully mitigate Its Impact on the school district's schools.
White (school district), Yellow (building department), Pink (applicant) feeform.xls (aros)denm
,f v�
BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM
O FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) •� t
❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD)
A PARADISE RECREATION AND PARK DISTRICT (PRPD)
❑ DURHAM RECREATION AND PARK DISTRICT (DRPD)
Assessor Parcel Number (s) (�jL�, OC�I�b' } Building Pei nit Number
Property Owner (s) C
Project Location /Address
Subdivision Name
Type of Residential Development (check one)
New Development
Alteration/Addition(s)
Mobile home
Demo Permit (date issued
Comments:
Building
Representative
Single Family -Detached
Non -Residential to Residential
Mobile home replacement
6_5
Date
Sq. Ftge 9
Single Family -Attached
Multi -Family Dwelling
verified by Assessor Department
verified by Building Department
❑ FRRPD ❑ CARD �PRPD ❑ DUD certifies that:
LOrc F�
e ec bm 4� ,f s 532-3E501
pplicant Name Phone Number
(a -{der (Z, V0- 0,V OrDVW- C# 9,594S
Mailing Address City State Zip
Has complied with requirements of the Butte County Board of Supervisors Resolution No. O Ul 9 %
by Payment of:
Dwelling Units @ $ per unit for a total of $ /
Square Feet @ $ Y per sq foot for a total of
Remarks:
Paid bt(Chbck No:
Park District
Paid by2Cash:
T .1Tll %XV%ITT TIT T1TTI!_ Cl Dl IC\ -...I. ___ ..•....A—A Fn roll 1 Ann
Receipt No:� / a
a o
Date
TO: . Building- Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
E.H. USE ONLY
Sol Plan Attached LI -I
Flow Man Attacftad-�:�
Sam to S.D.
12, 14-P717 A -
Owner Location
AP#
Plan'Approved for: Sewage Disposal
Water Supply:
Public
Private, Well
Clearance for.-� dwelling. Other /-Sg�7,6g-ox��—
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health
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